The future of electronic health records (EHR) is getting one step closer with aninvestment in a Canada Health Infoway project taking place in Saskatchewan.

Announced earlier this month, Infoway has invested $2.5

million in a development project with Saskatchewan Health to integrate a health care database system, known as the Provider Registry, with local health systems. While the project is based in Saskatchewan, it is being developed in consultation with the other western provinces, which together with Saskatchewan make up the Western Health Information Collaborative.

Saskatchewan Health’s role in the project is to implement interfaces between health care regions and the Provider Registry, which has already been developed as one of the core components of the national Infoway project. This includes diagnostic, laboratory, and drug information systems.

The Saskatchewan project, slated to launch in Spring 2004, is just one part of a plan to extend EHR systems throughout Canada, including a project undertaken in Alberta (see today’s Top Story).

“”The intention for Infoway is to invest in a solution, replicate it, and then deploy it across the country,”” said Susan Hyatt, vice-president of partnerships and alliances for Canada Health Infoway.

“”This project that we’re doing in Saskatchewan is the next step, if you will, the next level so we can take the work that’s already been done and integrate that registry with systems in the health region. This will allow us then to invest in those linkages and it will allow Saskatchewan to provide us with information on how to do this more quickly. It takes the basic Provider Registry project a few steps further,”” said Hyatt.

The Saskatchewan team, who expressed interest in the project after working on the Provider Registry within the context of the WHIC, is primarily involved in making the registry a usable tool that would transmit health-care provider information in a secure and efficient manner.

“”One of the challenges as we move to electronic records in the health-care space is that local health facilities systems use their own identifiers for health care providers,”” said Neil Gardner, executive director of health information solutions for Saskatchewan Health. “”Whenever you want to connect to a system or refer a patient, the one system couldn’t identify who the provider was.””

The purpose of the Provider Registry is to provide a single identifier across the provincial health system. In some ways it’s like a Yellow Pages or an index, Gardner said.

Gardner said that the systems will replace a certain amount of paperwork and manual labour, but that the key change will be in continuity of identifying the appropriate providers across the region in order to securely transmit data between health care providers.

“”For example, a private physician orders a lab test which gets processed within a hospital or a private lab. The results then could get sent back electronically to that physician. If the lab is going to communicate electronically back to that physician, it needs to be confident it is sending it to the correct electronic address,”” said Gardner.

On the most local levels, some changes will be required in how health care providers do day-to-day business now that they will be connecting directly to the Provider Registry. While the registry itself runs on HP servers using Windows 2000 and Websphere, the systems for the interface at the local user levels have yet to be determined.

“”Part of the project is to determine from a process point of view what is the most efficient way for (local providers) to implement this, and to develop the interface, the technical component, to speed tha,”” he said. “”For example when a new physician is added within a province, would that local hospital want a registry to publish that information to them? Would they want it done through a message, or would they want just simply at the end of the day a list of the new providers given to them and they would add them to their local system?””

The project involves working with the regions understanding their local systems and their business processes to figure out the most efficient way to update their local systems, said Gardner. In the future the system should be able to work in a two-way capacity, accepting address changes or other information from providers directly and updating them across the region through the Registry.

As the Provider Registry aims at providing standardized identifiers across regions, Hyatt admits that Infoway has a long way to go before all health care information is sailing smoothly across electronic channels nationwide.

“”We’re at the very beginning of this journey,”” said Hyatt. “”Our vision for interoperable electronic health records is gaining momentum. We’ve got proven solutions now that are becoming available and we’re taking them to the next level for reusability in other jurisdictions.””